Root Caries & when Prevention is not enough Flashcards
Comment on the statistic of having no natural teeth from 1968 to 1998
Fall from 37% to 13%
Comment on the relationship between age and root surfaces
- With age, more root surfaces exposed to the oral environment
- Therefore, the surface area of exposed roots exposed increases
- The exposed root surfaces are then susceptible to dental caries
Why may the gingivae recede? (2)
- With age
- Due to periodontal disease
Why don’t restorative materials work well on the root? (3)
- Structure of dentine
- Close proximity to gingival level
- Hard moisture control
Where are root caries located? (2)
- At cemento-enamel junction
- Apical to cemento-enamel junction
Why is it important to distinguish between cervical and root caries?
As treatment differs for both
What are some aetiological factors of root caries? (8)
- Root exposure
- Oral Hygiene
- Denture wearing
- Diet
- Saliva
- Fluoride
- Occlusion
- Cariogenic microorganisms
Comment on the proportion of acidogenic micro-organisms in plaque between older and younger patients
The proportion of acidogenic micro-organisms in plaque is generally higher in older people than in younger ones
How can removable dentures cause caries? (2)
- Plaque retention
- Food trapping
What does soft root caries lesion mean for the caries?
Extensive demineralisation, no evidence of intact surface mineral layer
What does leathery root caries lesion mean for the caries?
Active root caries
What does hard root caries lesion mean for the caries?
- Arrested
- Uniform distribution of mineral throughout lesion
How can you classify caries lesions? (2)
- Based on pattern of mineralisation
- Based on clinical features
Give some clinical features of active root caries (4)
- Well defined
- Soft, yellowish
- Light brown
- Covered by visible plaque
Give some clinical features of slowly progressive root caries (2)
- Brownish black
- Leathery
Give some clinical features of arrested root caries (4)
- Shiny
- Smooth
- Hard
- No microbial deposits
Comment on the fate of cementum after root exposure
What causes this to happen?
Cementum is loss from brushing
What are some diagnostic methods of root caries? (5)
- Dental History
- Visual and tactile examinations
- Radiographic examinations
- Caries Risk assessments
- Saliva tests
What are some alternative detection systems for root caries? (5)
- Digital Imaging of Radiographs
- Caries Detectors
- Electrical Caries Monitor (ECM)
- Fibre-Optic transillumination
- Laser Fluoresence System (DIAGNOdent)
How does an electrical caries monitor work?
The ECM utilises the fact that sound tooth tissue is a good insulator whereas demineralised tooth tissue is a poor insulator as it contains large quantities of waste
How does fibre optic transillumination work?
- Transillumination with a bright fiber-optic light depends on light scattering by the lesions
- Increased opacity of the enamel/dentine is the visual sign of early caries
How does the Laser Fluoresence System, DIAGNOdent work?
- This device measures laser fluorescence within tooth structure
- A sound tooth surface exhibits little or no fluorescence, resulting in very low scale readings on the display
What is the critical pH of enamel dissolution?
5.2-5.7
What is the critical pH of root substance dissolution?
6.0-6.7
Where can root caries spread?
Lesions may spread subgingivally
What pharmaceutical agents can be used in root caries treatment (4)
- Fluoride
- Chlorhexidine
- Triclosan
- Chlorhexidine and Thymol
Name some minimal intervention strategies for root caries (4)
- Fluoridated community
- Fluoride gel application at four-month intervals
- Fluoride varnish at three-month intervals
- Chlorhexidine varnish at three-month intervals
What restorative materials are used for intra-coronal restorations? (4)
- Glass ionomer cements
- Composites
- Resin Modified GICs
- Amalgam
